Levitan R D, Kaplan A S, Brown G M, Vaccarino F J, Kennedy S H, Levitt A J, Joffe R T
Clarke Institute of Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.
Arch Gen Psychiatry. 1998 Mar;55(3):244-9. doi: 10.1001/archpsyc.55.3.244.
There is emerging evidence of serotonergic dysfunction in patients with seasonal affective disorder (SAD). We examined central serotonergic function in female patients with SAD (fall-winter pattern) by means of neuroendocrine and subjective responses to the postsynaptic serotonin receptor agonist m-chlorophenylpiperazine.
Using a double-blind, randomized, placebo-controlled design, we assessed neuroendocrine and subjective responses to m-chlorophenylpiperazine (0.1 mg/kg intravenously) and placebo in 14 unmedicated female patients with SAD in the depressed state and 15 female normal controls. All testing was done in the fall-winter months and during the follicular phase of the menstrual cycle. Plasma prolactin and cortisol levels were used as neuroendocrine measures, while subjective responses were assessed by means of visual analog scales of 10 mood states.
On the basis of net responses to m-chlorophenylpiperazine (placebo effects subtracted from drug effects), patients with SAD exhibited blunted prolactin responses and less sadness than normal controls in response to the drug. When order of presentation of drug and placebo was taken into consideration, altered "calm" and "high" responses were also found in the patient group.
Evidence of dysfunction at or downstream to central serotonergic receptors in female patients with SAD confirms and extends findings from previous research.
有新证据表明季节性情感障碍(SAD)患者存在血清素功能障碍。我们通过对突触后血清素受体激动剂间氯苯哌嗪的神经内分泌和主观反应,研究了患有SAD(秋冬型)的女性患者的中枢血清素功能。
采用双盲、随机、安慰剂对照设计,我们评估了14名处于抑郁状态的未接受药物治疗的SAD女性患者和15名女性正常对照者对间氯苯哌嗪(0.1mg/kg静脉注射)和安慰剂的神经内分泌及主观反应。所有测试均在秋冬季节以及月经周期的卵泡期进行。血浆催乳素和皮质醇水平用作神经内分泌指标,而主观反应则通过10种情绪状态的视觉模拟量表进行评估。
基于对间氯苯哌嗪的净反应(从药物效应中减去安慰剂效应),SAD患者在用药后催乳素反应迟钝,且悲伤情绪比正常对照者少。当考虑药物和安慰剂的给药顺序时,患者组还出现了“平静”和“兴奋”反应的改变。
患有SAD的女性患者中枢血清素受体或其下游功能障碍的证据证实并扩展了先前研究的结果。